Gloucester resident Charlie Trasher says the Affordable Care Act has actually provided him with better care options in retirement than the plan he used for coverage while working four decades in the grocery business.

“It’s based on affordability, based on people’s income, and I know a lot of people need it to get any coverage,” Trasher, 62, told Congressman Joseph Kennedy III Friday. “How can they take that away?”

Trasher’s question to Kennedy, who serves on the House Energy & Commerce Committee that oversees federal health care reform, was just one of many posed by more than two dozen people who sat in on a 45-minute talk with the third-term congressman at the Gloucester Family Health Center on Washington Street.

The visit was part of Kennedy’s tours of four community health centers from Worcester to Taunton over the two days. The congressman, who represents Massachusetts’ 4th congressional district, listened diligently as local health officials and others pointed out the potential impact of a Republican-led repeal or stripping of provisions in the federal program known widely as “Obamacare.”

“It’s been inspiring to hear all of your words and see the world of community health centers,” Kennedy said, sitting in the middle of a circle that included, among others, Mayor Sefatia Romeo Theken, state Rep. Ann-Margaret Ferrante, D-Gloucester, North Shore Community Health Centers board chairman Jack Vondras, regional health centers Chief Operating Officer Christina Malagrida, and Angela Sanfilippo of the Gloucester Fishermen’s Wives Association and fishing partnership health care program.

“It’s also pretty troubling that the context in which I’m here is that some of my colleagues are preparing to gut Medicaid,” he said, referring to one of the prime funding targets of President Donald Trump and Republican congressional leaders.

Kennedy and Malagrida noted that the North Shore Community Health Centers — the umbrella agency for the Gloucester center, now in its ninth year — receives 40 percent of its revenue through Medicaid coverage of patient care.

“Without that, we could not hire the staff we need and wait for reimbursement,” Malagrida told Kennedy, a grandson of Robert F. Kennedy. “We need that money up front. We are barely surviving, and that’s under the current reimbursement rates.”

Vondras, who formerly served as the city of Gloucester’s heath director, painted a more dire picture.

“We would have to look at our sustainability (in the face of Medicaid and other Affordable Care Act cuts),” he said. “I’m not sure we could function.”

Concerns of coverage

Several of those addressing Kennedy raised concerns about potential cuts or a loss of coverage for victims of addiction and those who need coverage of mental health issues. That was also an issue raised the day before by the Police Assisted Addiction Recovery Initiative and its Gloucester-based board chairman, John Rosenthal. The group wrote letters to every member of Congress asking for continued support for projects such as the Gloucester police angel program, which steers addicts into treatment, but relies in part on an ACA provision mandating coverage for addiction patients.

Kennedy acknowledged that, and cited another category of coverage now threatened — coverage of pre-existing conditions. He noted that any changes to the Affordable Care Act’s mandated coverage of pre-existing conditions could impact coverage — a factor he said even some GOP lawmakers may not have considered.

“Once someone is in recovery, they are really in recovery for life,” Kennedy said. “Well, guess what that is — it’s a pre-existing condition.”

Romeo Theken and Ferrante — accompanied by her mother Frances, who is blind and battles other health issues — both cited a trickle-down effect that could come from a reduction or loss in coverage for addiction. Both noted that, if denied coverage for treatment, those caught in the grips of addiction would not enter treatment or seek help at community health centers, but go back to rushing to emergency rooms and create logjams for others needing acute care.

“Anything that is closed is going to impact every service we’ve all worked so hard to make a success for so many years,” said Romeo Theken, who worked in health care as Addison Gilbert Hospital’s community liaison before becoming mayor in 2015.

“There isn’t one, they have nothing,” he said. With that, he vowed to take the stories and concerns expressed here and at other community health center stops back to D.C., with words of encouragement for lawmakers to talk to patients in their own districts.

“We need to have some of the conservative members get out and listen to groups such as this,” he said. “Then let’s hear them look people like yourselves in the eye and say ‘I’m going to cut your budget.’ I’d ask them to go out and talk to patients in their own communities, see how this works — and hear what this will mean.”

For his part, Gloucester’s Trasher had another suggestion.

“Get people to stop calling it ‘Obamacare’,” he told Kennedy. “Call it for what it is, the Affordable Care Act — for good, affordable health care that people need.

“Call it anything,” he said. “Call it the Trump Plan, if that helps. That would be fine by me. But don’t take it away.”

Allison Kilcoyne, MS RN FNP-BC, Director of School Based Health North Shore Community Health visits with Senator Elizabeth Warren during a trip to Washington, DC in her capacity as Board member for the School-Based Health Alliance.